“Impact of Health Information System Downtime on the Delivery of Healthcare Services to Emergency Patients in Public Hospitals in the North of the West Bank” رسالة ماجستير

Abstract

Introduction Most health institutions, especially governmental ones in Palestine, have recently adopted electronic health records (EHR), or what is known as the health information system (HIS). HIS regulates all medical and administrative procedures in hospitals, from patient registration, diagnostics, x-ray requests, laboratory tests, medicines, to meals, pricing, and more. Despite the great importance of shifting from a paper-based system to an electronic system, this system is subject to many challenges, especially as it depends on the computer network and the Internet. Avoiding HIS downtime is a primary concern of the hospitals. Purpose of the Study The purpose of this study is to evaluate "the impact of Health Information System downtime on the delivery of healthcare services to emergency patients in public hospitals in the north of the west bank”. Methods of the Study The study was a cross-sectional study. The study included 4 governmental hospitals in the northern West Bank in Palestine. The study population consisted of124 employees, including 40 doctors and 76 nurses, in the emergency departments and 8 employees from the IT department of the four hospitals. Due to the small population size, the study sample consisted of all doctors, nurses and IT staff working in the targeted hospitals. In this study, a mixed approach (quantitative and qualitative) was used by designing two questionnaires, one directed to information technology employees and the other directed to doctors and nurses in the emergency departments. Data were analyzed using the IBM Statistical Package for Social Sciences (SPSS) version 25. VI Results One hundred and six out of 116 questionnaires were completed and returned to the researcher (response rate 91.38%). The results of descriptive statistics revealed that the downtime of the health information system affecting the workflow (mean=4.4490), increase crowding in the emergency department (mean=4.3367), causing a delay in requesting lab tests (mean=4.2551), causing delay in requesting the x-rays (mean=4.1633) and increase the length of a patient's stay in the emergency department (mean=4.0510). ANOVA test showed that there are statistically significant differences at the level (p≤0.05) in the average responses of the respondents about the extent of the impact of the HIS downtime on the health services provided to emergency patients due to the gender variable (p=0.039) and job title variable (p=0.0303). Conclusion The study found that the HIS downtime significantly affects the workflow and the provision of health services to patients. It emphasized the urgent need to adopt official plans and policies to deal with downtime and to train medical staff on that and sheds light on some of the reasons that increase the likelihood of downtime for HIS. Moreover, the study provided some recommendations to decision makers to help reduce the downtime of the HIS such as training the medical staff on how to deal with the downtime of the HIS, adopting the official downtime policy by the Ministry of Health and adopting a daily checklist for IT staff to ensure that the devices and various programs are working properly. More research is needed on the causes and effects of the downtime on data integrity and patient safety.